INTRODUCTION:

Colon cancer and rectal cancer, which originates in the rectum, are combined to form colorectal cancer. Colorectal cancer is another term for this type of cancer.

This cancer starts with the abnormal growth of cells in the first and longer section of the large intestine, known as the colon. The digestive system breaks down food for the body to use.

While colorectal cancer can affect people of any age, it primarily impacts older individuals. Typically, it begins with the development of polyps - small clusters of cells - within the colon. These polyps are non-cancerous, but some may eventually turn into cancer over time. Detecting and removing these polyps during screening tests can help prevent colorectal cancer.

Various treatments are available to manage or prevent CRC, includes surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

Many people with colorectal cancer don't experience any symptoms. Those who do may notice changes in bowel habits, such as increased constipation or diarrhea, blood in the stool, rectal bleeding, abdominal discomfort, weakness, fatigue, unintentional weight loss, or a feeling of incomplete bowel movements¹.

Causes:

· Colorectal cancer typically arises when cells inthe colon attain genetic mutations that cause them to develop and proliferate uncontrollably.

· The mutated cells continue proliferating, while normal cells die off as part of their natural life cycle. This abnormal cell growth leads to the formation of a tumor mass that can damage healthy body tissues.

· The term "metastatic cancer" refers to cancer that has spread to and established itself in other parts of the body, after the original tumor cells have broken away and traveled through the bloodstream or lymphatic system².

Preventions:

· Screening for coloncancer at the age of 45 can help prevent the risk. Individuals with a family history of colon or other cancer types are at a higher risk and should consider screening.

· Changing one's lifestyle can also reduce the risk of colon cancer, along with incorporating modern lifestyle modifications.

· Consuming a variety of whole grains, fruits, and vegetables that are rich in vitamins, minerals, fibers, and antioxidants can help decrease the risk of colorectal cancer.

· Regular exercise for at least 30 minutes most days of the week, along with maintaining a healthy body weight through a combination of a healthy diet and daily exercise, can also be beneficial.

· Reducing smoking and moderating alcohol consumption can further help in lowering the risk.

Natural Products used for CRC:

The natural products have garnered increased attention from researchers due to their fewer side effects and numerous advantages such as greater availability, biocompatibility, biodegradability, and cost-effectiveness. Below is a compilation of natural products that can be used for treating CRC.

Snake gourd:

The research paying attention on investigative effectiveness of snake gourd fruit and root extracts in suppress the development of colorectal cancer cells. The study concluded that the active constituent Cucurbitacin-B showed promising results in inhibit the intensification of colon cancer cell lines^3,4.

Rice:

Brown rice is a rich source of vitamins, minerals, and fibers. Additionally, rice bran contain a range of bioactive compounds that have been utilized in the management of CRC in humans. Avastin is a key medication for colorectal cancer. It is commonly used in the treatment of metastatic colorectal cancer (MCRC). Recent studies suggest that vasopressin may increase the risk of venous thromboembolism. Patients taking Avastin should consult their healthcare provider regarding these findings. Further investigation is needed to explore strategies for managing and preventing venous thrombosis in individuals undergoing treatment with Avastin^5,6.

Apple:

Apples are derived from the apple pomace of various apple varieties and have been demonstrated to reduce the abundance of cells associated with oral and colorectal cancer. Procyanidins are bioactive components in apple were utilized in colorectal cancer treatment. The purpose of the analysis was to examine the preclinical and clinical effects of these compounds and to outline the role of apple juice in preventing colon cancer via chemotherapy⁷.

Mangoes:

Mangoes are used for extracting various parts like the pulp, leaves, bark, and stem. The nuts and peels of mangoes are considered economical sources for colorectal cancer. Cetuximab, a drug, serves as active constituent in the dealing of CRC. An evaluation of the cost-effectiveness of cetuximab management for metastatic CRC in a resource-constrained healthcare environment is presented^8,9.

Oranges:

Oranges are extracting the peel is used to colorectal cancer. Capecitabine, an active ingredient, is utilized for the management of CRC. It is delivered directly to colon cancer cells through beta cyclodextrin-based nano polymeric micelles¹⁰.

Grapes:

Grapes seeds, peel and other grapes based on products are extracted. Resveratrol, an active ingredient derived from grapes, is consistently utilized in the treatment of colorectal cancer. The conclusion highlights the chemo sensitizing properties of this drug in colorectal cancer and its potential value as an adjunct to existing treatments^11,12.

Garlic:

Garlic leaves, flowers, and cloves have a long record of use in established medicine. Bevacizumab, a drug containing active constituents, is utilized for the treatment of colorectal cancer. Mariana Mihaila conducted research on the use of bevacizumab in treating metastatic CRC in real clinical environments. The aim of the recent study was to study the Romanian regulations regarding the regular administration of bevacizumab to Metastatic CRC patients. The formulations were developed by exchanging the buffer of the initial material^13,14.

Rhubarb:

Rhubarb is obtained by extracting the rhizome and root. Ramucirumab is an active ingredient utilized in the treatment of colorectal cancer. Chou-pincher was proposed and formulated based on the Ramucirumab drug. His publication has a Description of the literature from clinical trials on the use of Ramucirumab as a 2^ndline treatment for MCRC^15,16.

Cauliflower:

Cauliflower leaves are edible and it consists of Fruquintinib, an active constituent, is utilized for CRC. The FDA has sanctioned the use of Fruquintinib for metastatic CRC that has undergone prior treatment¹⁷.

Pomegranates:

Pomegranates seeds and peel are extracted. They contain Trastuzumab an active ingredient that is utilized in the treatment of colorectal cancer. Raghav Kanwal Pratap singh was recommended these publications on trastuzumab for a multi-center, open-label phase 2a multiple basket trial involving HER2 amplified metastatic CRC, as reported from pathway¹⁸.

Soya bean:

Soyabean fruits and seeds are utilized in the formulation of medications for colorectal cancer. Panitumumab drug an active ingredient that was effective in treating this type of cancer. Yunqiang Liu proposed a combined and Targeted DDS for the management of CRC. Rachel Wong focused on the Panitumumab for treatment of metastatic colorectal cancer¹⁹.

Hibiscus:

Hibiscus leaves and flowers are used to cure colorectal cancer treatment. Capecitabine was available in pills. Capecitabine is an active constituent utilized for CRC treatment²⁰.

Spinach:

Spinach inhibits the growth of colon polyps. Oxaliplatin, a potent drug, is utilized in the treatment of colorectal cancer. This 3^rdgeneration platinum compound has proven to be efficient in the treating of colorectal cancer1. The Combination of oxaliplatin and 5FU/LV has emerged as the latest recommended treatment for patients with advanced stage 3 and metastatic disease²¹. This combination therapy has shown promising results in improving the prognosis for both resected and metastatic patients.

Manilkarazapota:

Manilkarazapota, also known as sapodilla, is utilized in traditional medicine for treating colorectal cancer. Its leaves and bark are used in this type of treatment. Bevacizumab, a drug prepared from the sapodilla constituent, is a recombinant humanized monoclonal antibody. It is not only used for colorectal cancer but also to treat the other type of cancer such as pancreatic and breast cancer. Although it is considered a safe treatment, there have been concerns about potential side effects. However, recent studies in rats and mice have shows potential outcome, indicating a wider therapeutic variety²².

Peas:

The whole part of peas is used for treating colorectal cancer agents. Palmitoylethanolamide (PEA) is an active constituent which is used to cure colorectal cancer. The injection of um-PEA in vivo has a favorable effect on colonic cancers modelled by azoxymethanes, since it reduces the number of preneoplastic lesions and tumors²³.

Ginger:

Ginger has been discovered to possess inhibitory properties that can impede the growth and proliferation of colorectal cancer cells. The rhizome, an underground horizontal stem, is utilized in the preparation of medicine. 5-fluorouracil, derived from ginger rhizome, is a medication commonly used in the treatment of colorectal cancer. 1. The drug-loaded nanoparticles have demonstrated improved targeting to the colon and prolonged release for a duration of 24hours. By utilizing the same polymer in an optimal ratio to create nanoparticles, an effective drug delivery system can be established for targeted treatment of colorectal cancer²⁴.

Berberis vulgaris:

The pharmacological activity can be found in fruits, bark, root, and stem of berberis. Berberis vulgaris contains active constituents such as berberine, berbamine, and Palmi tine. Berberine, known for its significant antitumor effects, is a safe and effective agent. Fenbendazole, a drug used to treat colorectal cancer, utilizes parts of Berberis vulgaris in its preparation. Research indicates that the anti-cancer properties of fenbendazole, along with its ability to combat 5-fluorouracil resistance in cancer cells, could serve as a promising alternative treatment²⁵.

Vitex rotundifolia:

Vitex rotundifolia leaves and dried fruits are utilized in the formulation of medicinal products. These medications are employed in the management of colorectal cancer and various other types of cancer such as breast and lung cancer. 1. The molecular process by which Vitex rotundifolia (VF) hinders the production of CDK4 and cyclin D1, two elements linked to the growth of cancer cells. 1. The proliferation of colorectal cancer cells in humans was impeded by VF. Studies demonstrated that VF inhibited the activation of Wnt associated with the regulation of cyclin D1 transcription by reducing the expression of TCF4. 1. The proliferation of colorectal cancer cells in humans was impeded by VF. Studies demonstrated that VF inhibited the activation of Wnt associated with the regulation of cyclin D1 transcription by reducing the expression of TCF4²⁶.

Curcumin:

Curcumin, derived from the rhizome of turmeric, is a bioactive compound also known as diferuloylmethane. It is utilized in the production of drugs for colorectal cancer. Curcuminoids, which are chemical and phenolic compounds, fall under the category of curcuminoids. Oxaliplatin, a medication used in the management of CRC, is formulated using curcumin rhizome. Pharmacokinetics of oxaliplatin were assessed in a limited number of patients through the administration of an 85 mg/m2 infusion over two hours. Following an infusion of 130 mg/m2 of oxaliplatin, the drug was detected within 1-3 hours using liquid chromatography in combination with ICP-MS²⁷.

Broccoli:

A green member of the cabbage family is broccoli. Broccoli's flowering head, stalk, and leaves are utilized to make the medication that treats colorectal cancer. Sulforaphane, found in green leafy vegetables, is a medication used to treat colorectal cancer1. Research has demonstrated its ability to suppress UGT1A expression in colorectal cancer cells and hinder their growth via the ERK/Nrf2 signaling pathway. Additionally, sulforaphane is also effective in preventing and treating various other types of cancers such as skin, bladder, colon, prostate, and mouth cancers²⁸.

Emodin:

Emodin is derived from the Indian palmate plant. It can be located in the roots, leaves, bark, and trunk of the plant. Emodin has demonstrated efficacy in suppressing colorectal cancer cells. Additionally, it has been shown to impede HCT116 cell proliferation, adhesion, and migration. In a xenograft model, emodin was able to decelerate tumor growth. In the end, emodin emerges as a promising treatment option due to its ability to suppress the growth of colorectal cancer cells²⁹.

Rosmarinus officinalis (Rose marry):

Rosemary can be utilized in the management of CRC, with both culinary and medicinal applications for the plant's leaves and twigs. 5-Fu is frequently used in chemotherapy for colorectal cancer. The elements found in rosemary enhance the effects of 5-fluorouracil. Our research indicates that the therapeutic potential of this treatment, containing a beneficial ingredient for both sensitive and resistant tumor cells, is boosted in resistant cells by supercritical fluid rosemary extract (SFRE)³⁰.

Potato:

The entire potato is utilized in the production of medications for colorectal cancer. Solanine, a medication derived from potatoes, is effective in treating colorectal cancer. Solanine, a phytochemical extracted from traditional Chinese medicine, has demonstrated anti-cancer properties. The research delved into the molecular mechanism and possible function of solanine in controlling ferroptosis in colorectal cancer cells³¹.

Red onion:

Studies on phytochemistry have revealed that onions contain a high concentration of organo sulfur compounds and flavanols, which have been found to have tumor-inhibitory properties in laboratory tests. This medicinal use of onion bulbs has shown promising potential in the field of cancer treatment. Irinotecan is a drug which is used to cure colorectal cancer treatment. Irinotecan was investigated that the combination of irinotecan and fluorouracil has been approved as 1^st line chemotherapy for patients with MCRC, therefore serving as second line chemotherapy. This serves as the standard by which additional treatments must be evaluated in the future³².

Watermelon:

Watermelon seeds have been found to have potential benefits in the treatment of colorectal cancer. Arginine Demase has shown promise in suppressing colon cancer growth. The overactive arginine metabolism pathway in colorectal cancer makes it challenging to correct with pharmaceutical interventions targeting a single arginine transporter enzyme. In addition to its role in early-stage colorectal cancer screening, metabonomic analysis could be a valuable tool for detecting and screening colorectal cancer in the future, as polyamines are key metabolites of arginine³³.

Tomato:

Dry matter tomato paste is obtained from tomatoes by crushing them into crude tomato juice, which is then separated into serum and pulp. Capecitabine, a medication utilized in the management of CRC, has been formulated and evaluated in the form of drug microspheres specifically designed for this type of cancer³⁴.

Green tea:

The drug Cetuximab was derived from green tea leaves. Cetuximab is specifically designed for the management of CRC. It is considered the first line of defense against metastatic colorectal cancer. An economic evaluation model based in Indonesia was utilized. Thirteen systematic review and meta-analysis articles focused on the clinical outcomes of cetuximab therapy for colorectal cancer³⁵.

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Received on 31.07.2024 Revised on 15.10.2024

Accepted on 16.12.2024 Published on 03.05.2025

Available online from May 05, 2025

Asian J. Pharm. Res. 2025; 15(2):197-201.

DOI: 10.52711/2231-5691.2025.00032

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.